{$page->text()}

<div style="color:red; font-weight:bold; margin:20px;">{$msg}</div>

{if $send!=true}
<form onsubmit="checkValues()">
<input type=hidden name='request' />
<table>
	<tr>
		<td style="text-align:right;">
			First name<span class='red'>*</span>: 
		</td>
		<td>
			<input type=text name='name' size=25 value='{$name}'>
		</td>
	</tr>
	<tr>
		<td style="text-align:right;">
			Surname: 
		</td>
		<td>
			<input type=text name='surname' size=25 value='{$surname}'>
		</td>
	</tr>
	<tr>
		<td style="text-align:right;">
			Email<span class='red'>*</span>: 
		</td>
		<td>
			<input type=text name='email' size=25 value='{$email}'>
		</td>
	</tr>
	<tr>
		<td style="text-align:right;">
			City: 
		</td>
		<td>
			<input type=text name='city' size=25 value='{$city}'>
		</td>
	</tr>
	<tr>
		<td style="text-align:right;">
			Country: 
		</td>
		<td>
			<input type=text name='country' size=25 value='{$country}'>
		</td>
	</tr>
	<tr>
		<td style="text-align:right;">
			Number of participants: 
		</td>
		<td>
			<input type=text name='participants' size=25 value='{$participants}'>
		</td>
	</tr>
	<tr>
		<td style="text-align:right;" valign=top>
			Remarks:
		</td>
		<td>
			<textarea name='remarks' rows=5 cols=25>{$remarks}</textarea>
		</td>
	</tr>
</table>
	<span class='red'>Obligatory fields</span> <span class='red'>*</span>
	<br>
	<br>
	
	 Spam prevention question:<br>
	 Help us fight spam by authentifying yourself as a real user. <br>
	 Please enter the answer to {$num1} plus {$num2}
	 <input type=hidden name='a' value='{$numResult}'>
	 <input type=text name='test'> <br>
	 Make sure information is correct and press: <br>
	 <input type=submit>

</form>
{/if}
